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HIV Drug ResistanceHIV Drug Resistance
          
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cd4 16 vl 215000
Nov 22, 2002

Dera Dr. Little, Today 10/22, I went to the client @ USC Med Center, ( they're great there). I found out that My vl is as I reported 210K, but my cd4 is 16 my is 1.1. I had a VD, cifles(spelling) at stage 2, which they are treating with Becillian shots 2 a week for three weeks. I feel great, have had thrash, but thats been delt with. Had pcp 3 times. I was on a med holiday since, April this year, ( my doing) my PA started me today on the same combo I had last, Combvivir and Viramune. He suggest that we start here and in a month take a cd4 count and a vl, plus a resistance test. Do you think We should wait till then to take a resistance test or do you think this should be done now?

thank you for your time and information.

JV

Response from Dr. Little

It is possible that even if you had had drug resistance detectable back in April when you stopped your therapy - it may no longer be detectable (drug resistant virus frequently replaced by drug sensitive virus in patients who stop their treatment because of drug resistance). If you had previous drug resistance tests - I would use these with your history of treatment and toxicities to select a treatment regimen. If you stopped antiretroviral therapy in April at which time your viral load was undetectable, and you were taking combivir and viramune, then this may well work again. So - I don't think a resistance test now is absolutely necessary - but it depends a bit on what your prior treatment history was. I think that I would do one quickly if your viral load did not rapidly drop to undetectable though.


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